Delegation

Question 1

Leadership (macro)

Answer 1

interactive process that provides needed guidance and direction

Question 2

Delegation (micro)

Answer 2

transference of responsibility and authority to another competent healthcare worker (maintain accountability but transfer responsibility)

Question 3

Delegation is

Answer 3

professional activity, can delegate laterally to coworkers or down to UAP (ex: techs). delegation - power transferred (responsibility to perform a task) but remain ACCOUNTABLE. frees nurse to make judgments, use nurse process/coordinate care

Question 4

UAP

Answer 4

unlicensed assistive personnel - part of workload delegated tasks from nurses.

Question 5

Don’t delegate

Answer 5

medication, evaluation, assessment, teaching

Question 6

ANA definition of delegation

Answer 6

transferring responsibility for performance of an activity while retaining ACCOUNTABILITY for the outcome

Question 7

Delegate what doesn’t require nursing judgment

Answer 7

don’t delegate critical patient. UAPs don’t have same education - won’t pick up on subtle changes

Question 8

Benefits of delegation

Answer 8

increase pt satisfaction (more people taking care of needs), improve pt outcomes, help provide cost effective care (not paying RN to change beds), assist w/ good time management

Question 9

Rights of delegation (KNOW)

Answer 9

right task, right person, right circumstances, right communication, right feedback/eval/supervision

Question 10

right task

Answer 10

scope of practice - stable pt, predictable outcomes, minimal supervision, no FIRSTS (UAP used to taking care of)

Question 11

right person

Answer 11

qualified and competent

Question 12

Right circumstances

Answer 12

frequently occurring event on unit, lots of this type of pts, established sequence of steps/predictable outcome, NO FIRSTS

Question 13

right communication

Answer 13

communicate CLEARLY objectives, expectations, willingness to be available/they ACCEPT the job (be specific)

Question 14

right feedback/eval

Answer 14

performed correctly, timely, positive outcome, good communication, what challenges/learned. thank

Question 15

Delegating to UAPs

Answer 15

know state laws/hospital policy

Question 16

UAP tasks

Answer 16

vital signs, hygiene, positioning, gathering supplies, clerical/receptionist duties, trips/errands off the unit, clean floor, make bed, collect trays. know terminology but don’t know what it means

Question 17

UAP task verbs

Answer 17

remind, position, report, feed, bathe, ambulate (if you feel it is ok). NOT monitor, assess, evaluate, instruct, educate, triage, interpret, collaborate, plan.

Question 18

Don’t delegate nursing ________

Answer 18

process

Question 19

Getting organized

Answer 19

coordinate daily care/activities. delegation part of time management. need a worksheet to figure out what can be delegated

Question 20

When delegating consider

Answer 20

level of pt acuity, level of UAP personal capability, possibility of injury, number of times UAP has performed skill, level of decision making needed, fairness of the task (don’t dump on). supervise

Question 21

Delegating to LPN - licensed practical nurse (2 year degree)

Answer 21

task oriented, don’t evaluate, initiate care plans, complete initial assessments, check or start blood, and some states hang IVs or give IV push drugs. If delegable and unsure, have demonstrate first

Question 22

In delegation, the individual transfers the __________ to perform a specific activity from their own practice, to an individual ____________ to perform that task, but retains _____________ for the delegated task.

Answer 22

responsibility, qualified, accountability

Question 23

Delegation is a skill that must be _________ and _________ for proficiency

Answer 23

taught, practiced

Question 24

What are strategies for successful delegation?

Answer 24

id necessary skill/education level for task, plan ahead, select/empower capable personnel, communicate goals clearly, empower delegate, set deadlines/monitor progress, monitor role/provide guidance, eval performance/reward

Question 25

The final responsibility of the delegated task belongs to the _________

Answer 25

delegator

Question 26

Three common delegation errors

Answer 26

under delegating - lack of trust in subordinates, feel expected to handle everything. over delegating - poor time managers. improper delegating - wrong time, wrong person, wrong reason

Question 27

In assigning tasks to UAP, RN must be aware of _______, _________, and _______

Answer 27

job description, knowledge base, demonstrated skills

Question 28

Commonly delegated tasks for NAPs

Answer 28

noninvasive/nonsterile treatment, collect/report/document vitals, height, weight, I/Os, capillary blood, urine test, ambulation, positioning, turning, transport w/n facility, hygiene, elimination, enemas, feeding, ADLs

Question 29

What are some criteria for delegating?

Answer 29

frequently recur, standardized sequence of steps, no modification btwn pts, predictable outcome, no ongoing assessment/decision making, allowed by policy

Question 30

Never delegate the ________

Answer 30

nursing process

Question 31

Don’t delegate these to techs

Answer 31

new admissions, being discharged, transfers in/out, education, unexpected outcomes, pts w/ potential problems

Question 32

What can LPNs not do?

Answer 32

initial assessments, hang blood

Question 33

Decision tree

Answer 33

laws support, w/n scope, assessed client, w/n nap list, nap has skill/ability, policy, supervision